High-dose caffeine citrate in improvement of respiratory apnea and ventilation in premature infants
Objective To observe the efficacy and safety of high-dose caffeine citrate assisted mechanical ventilation in the treatment of premature infants with respiratory apnea(AOP).Methods One hundred and twenty-three children with AOP treated at Nanyang Central Hospital from June 2020 to March 2023 were selected for the randomized controlled trial.The enrolled children were divided into a conventional group(61 cases)and a high-dose group(62 cases)by the random number table method.Both groups received continuous positive airway pressure ventilation;the conventional group received a conventional dose of caffeine citrate to assist ventilation;the high-dose group received the maintenance dose of 10 mg/kg caffeine citrate to assist ventilation.The treatment statuses,improvement of apnea symptoms,improvement of lung function,and treatment safety were compared between the two groups.x2 and t tests were applied.Results The ventilation time,oxygen usage time,ICU stay time,and hospitalization time in the high-dose group were shorter than those in the conventional group[(4.25±1.33)d vs.(5.28±1.77)d,(4.02±1.47)d vs.(5.14±1.46)d,(5.12±1.36)d vs(6.65±2.43)d,and(10.25±3.41)d vs.(14.15±5.26)d],with statistical differences(t=3.65,4.24,4.32,and 4.89;all P＜0.05).The frequencies of apnea episodes within 24,48,and 72 h of the treatment in the high-dose group were lower than those in the conventional group[(8.44±2.23)times vs.(9.77±2.42)times,(6.36±1.47)times vs.(7.85±2.26)times,and(3.25±0.76)times vs.(4.49±1.47)times],with statistical differences(t=3.17,4.34,and 5.89;all P＜0.05).After the treatment,the tidal volume,peak time ratio,and peak volume ratio in the high-dose group were higher than those in the conventional group[(8.62±2.41)ml/kg vs.(7.33± 2.25)ml/kg,(36.77±10.61)％vs.(30.25±10.42)％,and(35.66±10.33)％vs.(29.77±10.41)％],with statistical differences(t=3.07,3.44,and 3.15;all P＜0.05).After the treatment,there was no statistical difference in the incidence of adverse events between the high-dose group and the conventional group[8.06％(5/62)vs.6.56％(4/61);x2=0.19;P=0.661].Conclusions High-dose caffeine citrate assisted mechanical ventilation in the treatment of children with AOP can effectively improve their symptoms of apnea and recovery process.Compared with the conventional maintenance dose,the high maintenance dose of caffeine citrate does not significantly increase the risk of adverse events,with high safety.
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